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A hybrid form of cardiac resynchronisation therapy in patients with failing systemic right ventricles

A hybrid form of cardiac resynchronisation therapy in patients with failing systemic right ventricles
A hybrid form of cardiac resynchronisation therapy in patients with failing systemic right ventricles
Introduction Late systemic right ventricular (RV) dysfunction after atrial redirection surgery is common. Patients may require cardiac transplantation in early adulthood.
Methods We undertook cardiac resynchronisation (CRT)/defibrillator therapy in two patients as a bridge to transplantation.
Results Two males (aged 24, 110 kg and 26 years, 106 kg); having undergone a Mustard procedure for dextro-transposition of the great arteries at 7 and 6 months of age respectively, presented with impaired systemic RV function and New York Heart Association III symptoms. Both patients had dual chamber pacemakers in-situ for sinus bradycardia. Upgrade to CRT was performed by conserving the existing endocardial leads and placement of epicardial electrodes. One demonstrated sustained improvement over a 24 month follow-up period.
Conclusion A hybrid CRT strategy is feasible in patients with failing systemic RVs and pre-existent endocardial dual chamber pacemakers. Appropriate patient selection criteria and optimum lead placement, however, still needs further evaluation in this population.
cardiac resynchronization therapy (CRT), heart failure, systemic right ventricle, dextro-transposition of great arteries (d-TGA), mustard surgery
1383-875X
229-233
Michael, Kevin A.
6f871ac1-2a55-46d3-a959-72e782925110
Paisey, John R.
4d958db6-f32d-4ce7-bef5-003a4a358312
Mayosi, Bongani M.
b70e784f-b719-4ffc-b072-7bdafc64ac14
Allen, Stuart
e8d968db-4cbc-4c0a-9ad7-775e4134f3df
Sunni, Nadia S.
9f7aea8b-a15e-4517-9ed4-6940f90ec0c0
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Morgan, John M.
98f0c249-3550-453a-9b06-bd27e9622744
Veldtman, Gruschen R.
d9b03375-5c07-46b8-9d85-8ac5b0f8e08a
Robinson, Stephen
ba591c98-4380-456a-be8a-c452f992b69b
Michael, Kevin A.
6f871ac1-2a55-46d3-a959-72e782925110
Paisey, John R.
4d958db6-f32d-4ce7-bef5-003a4a358312
Mayosi, Bongani M.
b70e784f-b719-4ffc-b072-7bdafc64ac14
Allen, Stuart
e8d968db-4cbc-4c0a-9ad7-775e4134f3df
Sunni, Nadia S.
9f7aea8b-a15e-4517-9ed4-6940f90ec0c0
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Morgan, John M.
98f0c249-3550-453a-9b06-bd27e9622744
Veldtman, Gruschen R.
d9b03375-5c07-46b8-9d85-8ac5b0f8e08a
Robinson, Stephen
ba591c98-4380-456a-be8a-c452f992b69b

Michael, Kevin A., Paisey, John R., Mayosi, Bongani M., Allen, Stuart, Sunni, Nadia S., Roberts, Paul R., Morgan, John M., Veldtman, Gruschen R. and Robinson, Stephen (2008) A hybrid form of cardiac resynchronisation therapy in patients with failing systemic right ventricles. Journal of Interventional Cardiac Electrophysiology, 23 (3), 229-233. (doi:10.1007/s10840-008-9296-0).

Record type: Article

Abstract

Introduction Late systemic right ventricular (RV) dysfunction after atrial redirection surgery is common. Patients may require cardiac transplantation in early adulthood.
Methods We undertook cardiac resynchronisation (CRT)/defibrillator therapy in two patients as a bridge to transplantation.
Results Two males (aged 24, 110 kg and 26 years, 106 kg); having undergone a Mustard procedure for dextro-transposition of the great arteries at 7 and 6 months of age respectively, presented with impaired systemic RV function and New York Heart Association III symptoms. Both patients had dual chamber pacemakers in-situ for sinus bradycardia. Upgrade to CRT was performed by conserving the existing endocardial leads and placement of epicardial electrodes. One demonstrated sustained improvement over a 24 month follow-up period.
Conclusion A hybrid CRT strategy is feasible in patients with failing systemic RVs and pre-existent endocardial dual chamber pacemakers. Appropriate patient selection criteria and optimum lead placement, however, still needs further evaluation in this population.

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More information

Published date: December 2008
Keywords: cardiac resynchronization therapy (CRT), heart failure, systemic right ventricle, dextro-transposition of great arteries (d-TGA), mustard surgery
Organisations: Dev Origins of Health & Disease

Identifiers

Local EPrints ID: 70482
URI: http://eprints.soton.ac.uk/id/eprint/70482
ISSN: 1383-875X
PURE UUID: 4c85ba3a-ed90-4fa5-89b6-ef66c29763bd
ORCID for Stephen Robinson: ORCID iD orcid.org/0000-0003-1766-7269

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Date deposited: 12 Feb 2010
Last modified: 13 Mar 2024 20:03

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Contributors

Author: Kevin A. Michael
Author: John R. Paisey
Author: Bongani M. Mayosi
Author: Stuart Allen
Author: Nadia S. Sunni
Author: Paul R. Roberts
Author: John M. Morgan
Author: Gruschen R. Veldtman
Author: Stephen Robinson ORCID iD

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